Healthcare Provider Details

I. General information

NPI: 1144131756
Provider Name (Legal Business Name): JOSE LUIS A SOLORZANO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 N TELSHOR BLVD
LAS CRUCES NM
88011-8277
US

IV. Provider business mailing address

901 BISON TRL
LAS CRUCES NM
88001-2315
US

V. Phone/Fax

Practice location:
  • Phone: 575-319-3167
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCTB-2026-0804
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: